Pediatric-hospital Plan Headed For Public Debate

Pediatric-care Plan Headed For Hearings

January 22, 1992|By FRANK SPENCER-MOLLOY; Courant Medical Writer

Newington Children's Hospital's three-year quest for a new medical center draws to a close with three public hearings, starting today, on its bid to build an $85 million, full-service pediatric facility at Hartford Hospital.

From the start, the two hospitals' plan has been held to a more exacting standard of community scrutiny than is usually given local hospitals' proposed major projects. At first, competing hospitals mounted a very public campaign, assailing the original plan for a larger children's hospital.

The business community, whose captains sit on hospital boards and who usually help smooth the way for costly expansions, decided this time to do things differently.

The Greater Hartford Chamber of Commerce was called in to referee, and it hired an independent health-policy analyst, which they hoped could divine whether more bricks and mortar met community needs or instead represented another example of empire-building by a hospital.

By contrast, since 1989, when the children's hospital first filed its plan with regulators, Yale-New Haven Hospital got state permission to build a $156 million expansion of its pediatric facilities, John Dempsey Hospital at the University of Connecticut Health Center in Farmington was allowed to spend $33 million on an expansion, and the Hospital of St. Raphael in New Haven was approved for a $22 million cancer center.

And, during the same period, a score or more new or expanded nursing homes, each costing $12 million or more, have won state approval.

The key question for the Commission on Hospitals and Health Care, when it opens three days of hearings at the Legislative Office Building today at 9:30 a.m., is whether the Hartford area needs a new hospital dedicated solely to pediatric care that is already largely offered, but spread out among, other area hospitals.

Two years ago the consultant, Lewin/ICF Associates of San Francisco, said that need exists, and meeting it would increase patient costs at both hospitals by about 4 percent within a few years.

The commission will also have to contend with another part of the plan, now thrown into doubt by the state attorney general.

It has been almost two years since Lewin set an expensive condition on the bid for a new hospital. Pointing to the desperate straits of most of the city's poor children, Lewin pronounced it unacceptable to go forward with plans for high-tech medical care without accounting for Hartford's more pervasive, basic medical needs among poor children.

Lewin called for the Newington hospital to dip into its $65 million endowment and to immediately set in motion a vehicle for providing free primary and preventive care for thousands of poor city children.

Two years later, that vehicle remains at or near the starting line. The hospital, while saying it wants to cooperate, balked at the $25 million recommended figure, setting its contribution at $15 million spread over several years.

In November, as the San Francisco consultant was drafting a response in which it held to the original $25 million figure, Attorney General Richard Blumenthal may have made the argument academic.

Blumenthal concluded that the hospital could not touch its endowment, amassed over decades, without violating the intentions of the fund's donors.

Jane Driscoll, director of community and human resources at the chamber of commerce, dismissed a suggestion that the opinion was an embarrassing setback for the chamber or that Lewin should have done its homework on the availability of the endowment.

"That was not their charge," Driscoll said.

But, she added, "we are very concerned about the attorney general's opinion, but we hope it can modified."

Driscoll and Thomas Hanley, a spokesman for Newington Children's Hospital, said the two organizations' lawyers are studying their options.

In papers filed with the commission, the hospital said it did not envision being able to touch the endowment, but reiterated its commitment to the child-care program through other sources.

Lewin will also largely stick to its guns, calling for reductions in the $85 million project and calling for hospital officials to lower their estimate of 83 medical-surgical beds and 34 intensive-care beds for newborns.

Also to be resolved is what role the University of Connecticut Health Center would play in a new pediatrics center. Lewin suggested transferring most of the academic and clinical programs from Farmington to the new hospital. In exchange, UConn would get broad authority to run the new hospital.

St. Francis Hospital and Medical Center in Hartford, which initially opposed the children's hospital but later endorsed the scaled-down version recommended by Lewin, sides with Lewin.

In return for its support, St. Francis is also asking that Hartford Hospital relax prohibitions it imposes on subscribers to its managed-care plans that bar patients from going to St. Francis and Mount Sinai hospitals, hospital spokesman Peter Mobilia said